Then & Now: Caring for War's Dead and Wounded

In the mid-1800s, America was a profoundly religious place. The circumstances of a person's death was thought to indicate much about the nature of one's afterlife; a "good death" meant passing at home surrounded by the family and friends one hoped to reunite with in heaven. The American Civil War upended these Christian notions of the proper way to die. On the battlefield, most soldiers died alone, anonymous, and without comfort, their families unaware of their fate.

Today, our government provides services for surviving veterans and their families, but it took the mass casualties of the Civil War to bring about this standard. The four-year war that claimed 2.5% of the American population caused the government to recognize the responsibility it owed to its soldiers and citizens, transforming the relationship between the nation and its people forever.

Before the Civil War:

There was no effective ambulance corps to transport wounded soldiers from the battlefields to aid locations. As late as August 1862, a Union division took the field at the Second Bull Run without a single ambulance. After numerous pleas to the government by public health advocates such as Henry Bowditch, an ambulance corps was finally established in 1864.

There were no federal hospitals providing comprehensive care. Wounded soldiers lucky enough to be rescued were taken to hastily established field hospitals constructed on an emergency basis. Volunteer relief groups, such as the U.S. Sanitary Commission, organized medical aid, while individual medical professionals such as Clara Barton bravely took to the battlefields to care for the wounded.

Soldiers did not wear dog tags or have any system of personal records. Hundreds of thousand of bodies remained unidentified, leaving families with no knowledge of how their loved one died, or where they might be buried. When officials did attempt identification, it was often unreliable, resulting in live soldiers being recorded as deceased and dead soldiers being marked as only slightly wounded. By World War I, soldiers were wearing official id badges.

There was no official system for notifying next of kin. If a body was identified, a fellow soldier might take it upon himself to write to the family of the deceased explaining how their loved one died and offering words of condolence. In the spring of 1865, Clara Barton established the Missing Soldiers Office in Washington, D.C. Her organization eventually helped provide information for about 22,000 soldiers who would have otherwise remained unknown.

There was limited technology available to preserve the war dead for proper burial. With so many families requesting that the bodies of their deceased loved ones be transported home, preservation methods had to evolve beyond simply keeping a body on ice. When the use of arsenic in embalming fluid became widespread during the Civil War, the Medical Department of the Union Army set up battlefield embalming stations to put this chemical advancement into practice. This allowed bodies to be preserved for the often long journey home.

Using refrigerated transportation cases for bodies was not common. In addition to the advancements in embalming fluids, refrigerated transportation cases were greatly improved to preserve the body on its often long, and slow journey back home. The Staunton Transportation Company distributed fliers claiming that its "portable refrigerator" cases preserved the body in perfect condition.

Federal services for veterans and their families were inadequate. After the war ended, the Nation's veterans assistance program expanded to include benefits and pensions not only for veterans, but also their widows and dependents. The first state veterans homes were also established which provided medical care even for injuries or diseases not acquired through battle. This paved the way for Congress to establish a new system of veteran's benefits when the U.S. entered World War I, which included disability compensation, insurance, and vocational rehabilitation for the disabled. In 1930, a comprehensive Veterans Administration was established, and today the system includes 152 hospitals, 800 outpatient clinics, 126 nursing home care units, and 35 domicillaries as well as numerous mental health and crisis prevention programs.

There were no national cemeteries at Arlington, Gettysburg, or anywhere. As there were no federal provisions for burying the dead, responsibility for clearing a battlefield of dead bodies fell to individual units, volunteer organizations, and even civilians. It was almost two full years after the end of the Civil War before Congress finally passed formal legislation to establish and protect a vast system of national cemeteries.

There was no Memorial Day. After the burial of many Union and Confederate soldiers, "decoration day" rituals began to spring up, which included placing fresh flowers on soldiers' graves. In the spring of 1868, General John Logan officially designated May 30th "for the purpose of strewing flowers or otherwise decorating the graves of comrades who died in the defense of their country," and Memorial Day as we know it today was established.

Today, the United States spends hundreds of millions of dollars a year trying to recover servicemen who are missing and presumed dead from World War II, Korea, and Vietnam. And with a $137.6 billion budget the Department of Veterans Affairs now offers dozens of programs, including medical and financial services.